| NPI | 1619077955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WI 41978) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 41978) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2023-02-08 |