| NPI | 1750395943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MI 4301063177) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.090082) |
| 208000000X Pediatrics (Licence: MI 4301063177) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-06-20 |