NPI | 1548551104 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TN 50725) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TN 50725) |
Enumeration Date | 2011-04-29 |
Last Update Date | 2022-03-31 |