NPI | 1003071242 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NJ 25MA10732300) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2017-00392) |
208000000X Pediatrics (Licence: CA A110346) | |
Enumeration Date | 2008-07-28 |
Last Update Date | 2023-02-06 |