| NPI | 1154430916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: VA 0101240810) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME0057738) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2022-08-09 |