| NPI | 1578710638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: MO 2011025489) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2011025489) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2024-04-25 |