| NPI | 1215291133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: GA 101201) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA AN 1992975-N-062) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 2019-01253) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2024-08-12 |