| NPI | 1225780398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME165190) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM 2021-0172) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NM 2021-0172) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NM MD2021-0172) | |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2024-06-27 |