| NPI | 1245597384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: ND 15004) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 64417) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MN 64417) | |
| 208000000X Pediatrics (Licence: ND 15004) | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2026-02-17 |