| NPI | 1225004815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: DC MDO46686) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: VA 0101036573) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2019-02-05 |