| NPI | 1942421102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: CO DR.0057229) |
| Additional Taxonomies | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: MO 2009014180) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2016-08-26 |