| NPI | 1043519309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.126742) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A152933) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A152933) | |
| 208000000X Pediatrics (Licence: CA A153432) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2019-08-29 |