| NPI | 1194455410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 84678-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.172445) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2025-07-15 |