NPI | 1740231455 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: ID M-10380) |
Additional Taxonomies | 208000000X Pediatrics (Licence: ID M10380) |
Enumeration Date | 2006-05-15 |
Last Update Date | 2018-04-25 |