| NPI | 1174903108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD464218) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MT208138) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2022-11-16 |