| NPI | 1164927208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036160503) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-50630) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2025-07-09 |