| NPI | 1962063198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 02006711A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5151013983) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2022-05-31 |