NPI | 1568427367 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX L3097) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX L3097) |
Enumeration Date | 2006-04-18 |
Last Update Date | 2013-08-13 |