| NPI | 1528244597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX Q3683) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301090411) |
| 208000000X Pediatrics (Licence: WI 53886) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WI 53886) | |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2015-08-17 |