| NPI | 1477916161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A173364) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.148870) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2026-01-06 |