| NPI | 1588771109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 38614) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 4301063581) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2024-05-07 |