| NPI | 1912369273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A152801) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A152801) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2023-03-24 |