| NPI | 1831340231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: UT 7849311-1205) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 248596) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2021-12-01 |