| NPI | 1639135668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MO 2012015953) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KS 04-38539) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2016-02-10 |