| NPI | 1467615914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 262607) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 51693) |
| Enumeration Date | 2008-07-04 |
| Last Update Date | 2023-12-27 |