| NPI | 1942261755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: UT 7061856-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L1968) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2022-04-25 |