| NPI | 1487767018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 25027) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MN 25027) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-07-08 |