| NPI | 1770639387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MT 11730) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AZ 79324) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2025-12-13 |