| NPI | 1366401960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35-062494) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MD045935L) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A44109) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NM MD2014-0041) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35062494H) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2019-05-14 |