| NPI | 1518251636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WA MD61401139) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A124852) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2023-02-27 |