| 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) |
| 207R00000X Internal Medicine (Licence: TX S1388) | |
| 208000000X Pediatrics (Licence: TX S1388) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2022-11-21 |