NPI | 1578673448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MD020218E) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AL 24896) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2013-04-15 |