| NPI | 1013903855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA C157550) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KY C1779) |
| 208000000X Pediatrics (Licence: KY C1779) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: LA 325679) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: IA 32976) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: KY C1779) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2024-08-14 |