| NPI | 1467747659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MO 2020001532) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NE 29938) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2021-01-18 |