| NPI | 1598797763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036070968) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 26982020) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-04-20 |