| NPI | 1386031391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036.154446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.154446) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2026-05-09 |