NPI | 1477692465 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX P4349) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NM 2006-0350) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2019-03-15 |