| NPI | 1902034713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NV 15803) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 15803) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2015-11-06 |