| NPI | 1093826430 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MO 2019033020) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 22864) | 
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NE 22864) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KS 04-42498) | |
| Enumeration Date | 2006-08-31 | 
| Last Update Date | 2023-02-10 |