| NPI | 1235202029 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA G200378) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AL MD.33559) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2025-01-31 |