NPI | 1194930198 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME117408) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME117408) |
208000000X Pediatrics (Licence: MI 4301086030) | |
208000000X Pediatrics (Licence: SD 7325) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN18047) | |
Enumeration Date | 2007-05-11 |
Last Update Date | 2019-07-02 |