NPI | 1235395872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 274258) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT192372) |
Enumeration Date | 2008-08-04 |
Last Update Date | 2022-07-21 |