| NPI | 1326066887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA G158847) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO R8845) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MO R8845) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-06-05 |