| NPI | 1215146345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N7789) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: IA 36677) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2022-01-31 |