| NPI | 1427075035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX M2800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101-045906) |
| 207P00000X Emergency Medicine (Licence: SC 27118) | |
| 207P00000X Emergency Medicine (Licence: OH 35.079426) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2012-10-18 |