| NPI | 1679982680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX BP10059539) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125064749) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2022-07-21 |