| NPI | 1013188408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036128459) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 257716) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2018-06-04 |