| NPI | 1467832428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036.150006) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.150006) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2020-06-17 |