| NPI | 1043538150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C173179) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 244039) |
| 208000000X Pediatrics (Licence: IL 036-133245) | |
| 208000000X Pediatrics (Licence: IL C173179) | |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2023-04-05 |