| NPI | 1184764706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036111882) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036111882) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IL 36111882) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2021-02-04 |