| NPI | 1902260243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.136133) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.136133) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2023-11-13 |