NPI | 1114318078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.129165) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.129165) |
Enumeration Date | 2015-02-13 |
Last Update Date | 2024-02-02 |