| NPI | 1245597384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: ND 15004) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2015015503) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208000000X Pediatrics (Licence: MO 2015015503) | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2023-01-23 |