| NPI | 1083817886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036147159) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ND 11730) |
| 208000000X Pediatrics (Licence: MI 4301085525) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2024-03-04 |