| NPI | 1417066242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G36254) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA G36254) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2008-07-22 |