| NPI | 1730135203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: SC 23678) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 23678) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2026-08-31 |