| NPI | 1225213804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: GA 057547) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME104551) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2016-03-15 |