| NPI | 1699937458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 2020-02976) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA MD443905) |
| 208000000X Pediatrics (Licence: PA MD443905) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2024-02-09 |