| NPI | 1861422396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 20022) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 20022) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AL 20022) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2013-06-12 |