| NPI | 1275855595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME106643) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 247500) |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2019-10-03 |