| NPI | 1952508749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KY 60044) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.091472) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME113732) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2025-04-10 |