| NPI | 1689054611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MT208218) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT208218) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2018-06-14 |