| NPI | 1962782805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01073782A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125060428) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2021-12-10 |