| NPI | 1316101892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036127588) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R1562) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2013-01-15 |