| NPI | 1134228265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: SC 32324) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M4041) |
| 208000000X Pediatrics (Licence: SC 32324) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2018-03-23 |