| NPI | 1013993344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MT MED-PHYS-LIC-91121) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2008012523) |
| 208000000X Pediatrics (Licence: IL 036129394) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2026-07-08 |