| NPI | 1942564380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL 135884) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125060888) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2018-08-24 |