| NPI | 1487036851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 6477-851) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125067574) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2022-07-26 |