| NPI | 1831306034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AZ 38239) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35088164) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2019-07-24 |