| NPI | 1598198368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX R6026) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OK 37815) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2022-08-04 |