| NPI | 1750369468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AL 11501) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 10748) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NV 10748) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2023-03-07 |