| NPI | 1245487404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: LA MD.203819) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.052705) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2021-05-14 |