| NPI | 1417117482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: MA 265453) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 236572) |
| 208000000X Pediatrics (Licence: MO 2009026062) | |
| 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: CA A116631) | |
| 208000000X Pediatrics (Licence: MA 265453) | |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2016-02-23 |