| NPI | 1922312230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX p8109) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P8109) |
| 208M00000X Hospitalist (Licence: TX P8109) | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2019-02-15 |