NPI | 1952747420 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: MA 282535) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 270786) |
2080P0206X Pediatrics Pediatric Gastroenterology (Licence: MA 270786) | |
Enumeration Date | 2013-05-10 |
Last Update Date | 2020-06-18 |