| NPI | 1154647550 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IL 113000057) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 113000057) | 
| Enumeration Date | 2010-04-12 | 
| Last Update Date | 2013-03-11 |