NPI | 1417397472 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WV 30353) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2013022089) |
Enumeration Date | 2013-07-04 |
Last Update Date | 2022-04-06 |