| NPI | 1578095584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 303970) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 303970) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2023-10-26 |