| NPI | 1659529394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME128281) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME128281) |
| Enumeration Date | 2008-09-07 |
| Last Update Date | 2020-03-11 |