| NPI | 1467746818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 75177) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.153077) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2023-09-06 |