| NPI | 1902073273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: DC MD039912) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: VA 0101247310) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2014-07-02 |