| NPI | 1073722112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: IA 37164) |
| Additional Taxonomies | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: IA R-7397) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2010-02-09 |