| NPI | 1467642207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C51875) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA C51875) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2021-04-09 |