| NPI | 1285738757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 32036) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-092497) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2020-12-23 |