| NPI | 1912048703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AZ 50552) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 50552) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2026-01-01 |