| NPI | 1558750430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036.148502) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2016020251) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2019-05-16 |