| NPI | 1598921462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CO DR.0047800) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 57.012341) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2021-06-22 |