| NPI | 1053871962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5101028059) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.157711) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-08-27 |