| NPI | 1548523772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MD D0083795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.139714) |
| 208000000X Pediatrics (Licence: IL 036.139714) | |
| 208D00000X General Practice (Licence: IL 125-060812) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2018-09-13 |