| NPI | 1477013498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA 20A25688) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D95927) |
| 208000000X Pediatrics (Licence: CA 20A25688) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2026-07-28 |