| NPI | 1447440573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA C152872) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 231318) |
| 208000000X Pediatrics (Licence: MT MED-PHYS-LIC-113516) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MA 231318) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX V9805) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2025-08-12 |