| NPI | 1649268368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: NH 14207) |
| Additional Taxonomies | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: CT 039007) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2016-09-07 |