| NPI | 1508494287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: SC 89687) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.077140) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2023-05-09 |