| NPI | 1568586428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A107774) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036117918) |
| Enumeration Date | 2007-03-18 |
| Last Update Date | 2017-01-20 |