NPI | 1073660890 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA C173859) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA C173859) |
2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.122054) | |
2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TN 477HWQ) | |
Enumeration Date | 2007-01-04 |
Last Update Date | 2024-04-10 |