NPI | 1548362361 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A43306) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A85869) |
Enumeration Date | 2006-09-02 |
Last Update Date | 2012-10-03 |