| NPI | 1427069525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: MO R3B41) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO R3B41) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2015-08-26 |