| NPI | 1568813269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: IL 036.160891) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: FL ME175958) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2025-10-13 |