NPI | 1306102835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: IL 036146930) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA Not Yet Licensed) |
Enumeration Date | 2012-04-10 |
Last Update Date | 2018-08-02 |