| NPI | 1558372185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: CA G53221) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G53221) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2018-11-29 |