| NPI | 1962459792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 151092) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MA 151092) |
| 208000000X Pediatrics (Licence: AR E-15588) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AR E-15588) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2025-12-04 |