| NPI | 1225239346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX M6675) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M6675) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-09-16 |