| NPI | 1811216948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 257025) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 257025-1) |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2017-05-11 |