NPI | 1932413168 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NM MD2015-0835) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301096421) |
208000000X Pediatrics (Licence: WI 60082) | |
Enumeration Date | 2010-07-29 |
Last Update Date | 2023-11-17 |