| NPI | 1174782395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX N3022) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: LA MD.202448) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2021-03-12 |