| NPI | 1083885214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: VA 0101243680) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A90971) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MD D0067583) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MI 4301101793) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NM MD20120578) | |
| Enumeration Date | 2008-03-15 |
| Last Update Date | 2013-12-20 |