NPI | 1275752479 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MO R5D38) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KS 04-20290) |
Enumeration Date | 2007-04-25 |
Last Update Date | 2007-07-08 |