| NPI | 1932562956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX V0126) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX V0126) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NE 30429) | |
| 208D00000X General Practice (Licence: NE 30429) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-07-03 |