| NPI | 1265471312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036106335) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00044559) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-07-14 |