| NPI | 1942280433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC MD40715) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 01035898A) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2022-07-22 |