| NPI | 1639143100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MD073139L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD073139L) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2019-02-18 |