| NPI | 1215959515 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IL 036105873) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 45376-20) | 
| Enumeration Date | 2006-07-24 | 
| Last Update Date | 2023-01-23 |