| NPI | 1093120263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: IA DO-05519) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA DO-05519) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2023-12-18 |