NPI | 1972725174 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: IL 036131843) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WI 64430-20) |
207R00000X Internal Medicine (Licence: IL 036131843) | |
Enumeration Date | 2007-05-03 |
Last Update Date | 2015-08-06 |