| NPI | 1366898058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 81217-21) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125068076) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2023-07-03 |