| NPI | 1265819601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 322970-01) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 61782) |
| 208000000X Pediatrics (Licence: NY 322970-01) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MN 61782) | |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2024-05-01 |