NPI | 1639198914 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MD071261L) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD071261L) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2013-04-15 |