| NPI | 1073930053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: RI MD16739) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 1073930053) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2019-06-12 |