| NPI | 1679060503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 287049) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MA 287049) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2024-04-30 |