NPI | 1174935019 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WI 69057) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AZ 009032) |
Enumeration Date | 2014-05-27 |
Last Update Date | 2022-05-02 |