| NPI | 1164467114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: VA 0101239467) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101239467) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2009-12-16 |