NPI | 1235161712 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WA MD00035982) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA md00035982) |
208000000X Pediatrics (Licence: WA MD00035982) | |
Enumeration Date | 2006-07-07 |
Last Update Date | 2021-08-29 |