| NPI | 1801358049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MO 2023020163) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2023020163) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2025-12-02 |