NPI | 1003018730 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: GA 104882) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CO DR-50219) |
Enumeration Date | 2007-06-04 |
Last Update Date | 2025-09-09 |