| NPI | 1407807159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MS 22991) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A71473) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A71473) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2017-04-20 |