| NPI | 1215430020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036.155413) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.072076) |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2021-05-10 |