| NPI | 1700318292 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A170359) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A170359) | 
| Enumeration Date | 2017-04-03 | 
| Last Update Date | 2025-09-10 |