NPI | 1801028451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MA 250927) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 240745) |
Enumeration Date | 2009-08-16 |
Last Update Date | 2015-05-06 |