| NPI | 1043491426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036132909) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301090550) |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2020-10-30 |