| NPI | 1831489996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.123879) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.123879) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2018-05-31 |