NPI | 1225213804 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: GA 057547) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME104551) |
Enumeration Date | 2008-01-02 |
Last Update Date | 2016-03-15 |