| NPI | 1295802882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036095398) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036095398) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2011-11-14 |