| NPI | 1932413168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NM MD2015-0835) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301096421) |
| 208000000X Pediatrics (Licence: WI 60082) | |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2025-02-13 |