| NPI | 1033200191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 233391) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0064632) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2014-05-23 |