| NPI | 1427140300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: FL ME108688) |
| Additional Taxonomies | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: DE C10007608) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2016-11-11 |