| 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 |