| NPI | 1528227212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ND 11986) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036121076) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2022-02-22 |