| 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 |