| NPI | 1053674382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MT201276) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT201276) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2019-06-25 |