| NPI | 1740222314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G36232) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G36232) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2008-07-30 |