| NPI | 1396904967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: NC 200542) |
| Additional Taxonomies | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: SC 93028) |
| Enumeration Date | 2008-06-08 |
| Last Update Date | 2024-09-10 |