| NPI | 1487682753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX L4097) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX L4097) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2011-03-30 |