| NPI | 1790961399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.087748) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.087748) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2021-04-09 |