| NPI | 1194911123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 2009-00075) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2009-00075) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2023-12-18 |