| NPI | 1821271735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TN MD51355) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 28478) |
| 208000000X Pediatrics (Licence: TN MD51355) | |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2022-03-14 |