| NPI | 1003979063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 2018-01805) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2006026942) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2021-03-02 |