NPI | 1952508749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME113732) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.091472) |
Enumeration Date | 2007-06-27 |
Last Update Date | 2012-08-30 |