| NPI | 1457711707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: VA 0101263205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101263205) |
| 208D00000X General Practice (Licence: VA 0101263205) | |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2025-06-04 |