| NPI | 1386684264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 10229R) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: LA 10229R) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2013-02-20 |