| NPI | 1932368206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KY 53116) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 250674) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KY TP674) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MA 250674) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2020-01-03 |