| NPI | 1295960284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MD473315) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 45361) |
| 208000000X Pediatrics (Licence: OH 35.136350) | |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2026-04-21 |