NPI | 1164457560 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NH 15360) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KY 34403) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2012-03-27 |