| NPI | 1144354440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: TX N3263) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N3263) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2012-01-10 |