| NPI | 1972725174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: IL 036131843) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WI 64430-20) |
| 207R00000X Internal Medicine (Licence: IL 036131843) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2015-08-06 |