| NPI | 1689736043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: LA 300245) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C161299) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35097380) | |
| 208000000X Pediatrics (Licence: NY in process) | |
| 208000000X Pediatrics (Licence: LA 300245) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA C161299) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2024-03-22 |