| NPI | 1528258613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MD437642) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT190902) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2013-05-09 |