| NPI | 1033317540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MI 4301090361) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301090361) |
| 208000000X Pediatrics (Licence: OH 35.097440) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2021-02-24 |