| NPI | 1285034082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.142944) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 56163) |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2021-11-10 |