| NPI | 1952458747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MT 49836) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WA MD60021216) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2023-11-27 |