| NPI | 1467807354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL 139694) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: GA 97958) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TN 0000065057) | |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2024-11-05 |