| NPI | 1114004652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036076951) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-076951) |
| 207R00000X Internal Medicine (Licence: IL 036076951) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-03-01 |