| NPI | 1710172853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NJ 25MA08165200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08165200) |
| 208000000X Pediatrics (Licence: NJ 25MA08165200) | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2020-06-30 |