| NPI | 1427075852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MD D30979) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KY 38758) |
| 208000000X Pediatrics (Licence: MD D30979) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2013-08-19 |