| NPI | 1366456543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301048129) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MI 4301048129) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2013-10-14 |