| NPI | 1447488853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: TN MD52961) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0116021125) |
| 208000000X Pediatrics (Licence: TN MD52961) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2022-03-16 |