| NPI | 1891747507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 9900967) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WI 46663) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2014-05-13 |