| NPI | 1043405244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MD D82255) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 295796) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35 121122) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2023-06-30 |