| NPI | 1396838876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MO 2007002166) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KY 60035) |
| 174400000X Specialist (Licence: MO 430654872) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-10-04 |