| NPI | 1184859175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX S1415) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: GA 63345) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A118198) | |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2021-04-19 |