| NPI | 1801162870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: NY 272557) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 272557) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2023-03-27 |