| NPI | 1164757852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: AR E-16456) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 151561) |
| 208000000X Pediatrics (Licence: AR E-16456) | |
| 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: MI 4301090985) | |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2023-06-15 |