| NPI | 1952420515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: ME MD21195) |
| Additional Taxonomies | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: MA 237450) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2025-04-15 |