| NPI | 1417958133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036-049107) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IL 036-049107) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2022-05-23 |