| NPI | 1316107196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 52955) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036121303) |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2013-05-02 |