| NPI | 1437530409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 315950) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301107545) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2022-08-10 |