| NPI | 1043638679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 280592) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 280592) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2025-08-04 |