| NPI | 1366646150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ID O-0532) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-051457) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2009-12-18 |