| NPI | 1366475303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036-096100) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO MD106450) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2007-07-09 |