| NPI | 1477692465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX P4349) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ P4349) |
| 208000000X Pediatrics (Licence: NM 2006-0350) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2026-05-06 |