NPI | 1487738811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA G34798) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NM MD 2013-0785) |
Enumeration Date | 2006-10-24 |
Last Update Date | 2025-01-24 |