| NPI | 1386034700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NE 28528) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 28528) |
| Enumeration Date | 2015-01-24 |
| Last Update Date | 2022-07-11 |