| NPI | 1003883281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI L1007442) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-103970) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2021-03-02 |