| NPI | 1104892231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 36103232) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036103232) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2009-07-23 |