| NPI | 1245294586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: UT 177150-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.151350) |
| 208000000X Pediatrics (Licence: UT 177150-1204) | |
| 208000000X Pediatrics (Licence: CA 20A17355) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2023-02-07 |