| NPI | 1104115682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 2018-00299) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2018-00299) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2024-07-15 |