| NPI | 1962962092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: IN 01090272A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01090272A) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2024-12-23 |