| NPI | 1740386911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO R8H17) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OK 29238) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2017-02-01 |