NPI | 1831306034 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: AZ 38239) |
Additional Taxonomies | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: OH 35088164) |
Enumeration Date | 2007-05-17 |
Last Update Date | 2019-07-24 |