| NPI | 1003270208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: VA 0101279064) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101279064) |
| 208000000X Pediatrics (Licence: NC 2020-01430) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 2020-01430) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 32396) | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2024-10-30 |