| NPI | 1568615060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NJ 25MA08458200) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 236346) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2010-11-23 |