| NPI | 1063916633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A164904) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A164904) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-04-25 |