| NPI | 1346543378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: MI 4301102350) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 257978) |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2023-11-27 |