| NPI | 1033134713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 9288) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-174033) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2025-09-23 |