| NPI | 1225013527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: CA C195049) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME142129) |
| 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: FL ME142129) | |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2024-06-20 |