| NPI | 1427031970 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA C164935) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C164935) | 
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MD443923) | |
| Enumeration Date | 2005-11-29 | 
| Last Update Date | 2024-04-10 |