NPI | 1023313772 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A116897) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX N8431) |
208000000X Pediatrics (Licence: CA A116897) | |
Enumeration Date | 2011-01-11 |
Last Update Date | 2025-06-18 |