| NPI | 1639348832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MD482581) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 59958) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WI 59958) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2023-11-29 |