| NPI | 1114946605 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME114359)  | 
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: IL 036-081400)  | 
| 207RI0008X Internal Medicine, Hepatology (Licence: FL ME114359)  | |
| Enumeration Date | 2006-07-18 | 
| Last Update Date | 2012-11-08 |