| NPI | 1801030077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: NE 25968) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 25968) |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2021-07-27 |