| NPI | 1184630808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD039755E) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: PA MD039755E) |
| 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: PA MD039755E) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-01-28 |