NPI | 1487941969 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036135756) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT200569) |
Enumeration Date | 2011-07-05 |
Last Update Date | 2014-10-10 |