| NPI | 1154470987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX N9284) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N9284) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2021-12-17 |