| NPI | 1194799684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036118219) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 47590) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2014-05-16 |