| NPI | 1922277813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 236168) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 236168) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2019-07-10 |