| NPI | 1164800116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IL 036.160271) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.133264) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2022-09-07 |