| NPI | 1962848069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA 141782) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2016-06-27 |