| NPI | 1750471645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA LT000881) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA TR00044541) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WA TR00044541) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-07-27 |