| NPI | 1285040816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 55018) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.065978) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2019-07-23 |