| NPI | 1033370481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101245012) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-051348) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2022-09-09 |