| NPI | 1952832503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MI 4301509755) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10955777-1205) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2023-09-15 |