NPI | 1801215215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX R4273) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.142960) |
Enumeration Date | 2014-04-14 |
Last Update Date | 2024-07-16 |