| NPI | 1497779904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: PA MD038123E) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD038123E) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2014-10-23 |