| NPI | 1487738811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA G34798) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NM MD 2013-0785) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2023-07-12 |