| NPI | 1124039813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PR 15346) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-115444) |
| 2080T0004X Pediatrics, Pediatric Transplant Hepatology (Licence: PR 15346) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-01-26 |