NPI | 1396957247 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: IL 036047431) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036047431) |
Enumeration Date | 2007-05-04 |
Last Update Date | 2013-07-26 |