| NPI | 1588914857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MO 2023010883) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME137081) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2023-06-20 |