| NPI | 1821651019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME174167) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME174167) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2025-05-19 |