NPI | 1093766875 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NJ mb072525) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: DE c2-0007817) |
Enumeration Date | 2006-05-15 |
Last Update Date | 2013-05-21 |