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 |