| NPI | 1790097053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: ME MD21003) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ME MD21003) |
| 208000000X Pediatrics (Licence: PA MT197600) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2025-03-17 |