| NPI | 1982626537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA C51575) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX K4448) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2023-03-07 |