| NPI | 1033243191 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MI 4301085143) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301085143) | 
| Enumeration Date | 2007-03-14 | 
| Last Update Date | 2018-11-27 |