| NPI | 1689837932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 2016-01612) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AZ 46053) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 2419621) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CT 046767) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2024-02-09 |