| NPI | 1356372924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA C138035) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX N7631) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 002125) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2016-08-31 |