| NPI | 1851330138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CO 39946) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: VA 0101234399) |
| 208000000X Pediatrics (Licence: VA 0101234399) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2022-12-28 |