| NPI | 1063093094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WA 70069204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 70069204) |
| 2080B0002X Pediatrics, Obesity Medicine (Licence: WA 70069204) | |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2026-01-17 |