| NPI | 1053421636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AZ 60507) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX L6564) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-12-10 |