| NPI | 1184806358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AZ 62845) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 62845) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2024-07-09 |