| NPI | 1144354945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: LA 321248) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WA MD60085838) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2019-12-11 |