| NPI | 1467570945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NH 17043) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.090484) |
| 207R00000X Internal Medicine (Licence: OH 35.090484) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2015-07-21 |