| NPI | 1568437721 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MO 2015044366)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2015044366)  | 
| Enumeration Date | 2006-02-21 | 
| Last Update Date | 2025-04-17 |