| NPI | 1700957107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: NY 149050) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 149050) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-05-29 |