| NPI | 1083761803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CT 045284) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 226905) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2016-09-07 |