| NPI | 1598260523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 311651-01) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 010611) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2024-07-25 |