| NPI | 1912088550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: IN 01077656A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 40431) |
| 208000000X Pediatrics (Licence: IN 01077656A) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2018-08-13 |