| NPI | 1750728499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KY 04541) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 34.013557) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2024-08-26 |