| NPI | 1811928047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MI 4301055501) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI MA055501) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-10-23 |