| NPI | 1154663623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 006886) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125062832) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2016-09-06 |