| NPI | 1891747507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX V7599) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX V7599) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WI 46663) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 9900967) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2025-06-20 |