| NPI | 1487919155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A167536) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125062383) |
| 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: CA A167536) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2020-03-09 |