| NPI | 1346650405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: UT 10272482-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP1-0049373) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2021-12-15 |