| NPI | 1629564042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AR E-17673) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR E-17673) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301114824) | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2024-06-21 |