| NPI | 1154640860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A156606) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 72546) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2023-09-21 |