| NPI | 1407931140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036158039) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 40048) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-08-24 |