| NPI | 1588659809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TN MD35433) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD35433) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2022-02-15 |