| NPI | 1700080538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: IA MD-38930) |
| Additional Taxonomies | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: WI 82944) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-12-28 |