| NPI | 1205299708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 2023-01264) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.138849) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.138849) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2023-08-24 |