| 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 |