| NPI | 1073541272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MA 45839) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 45839) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2007-10-27 |