| NPI | 1497878680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: SC 87556) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 34.009263) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA OS015511) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2022-08-04 |