| NPI | 1609258474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IL 036.145864) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125067837) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2018-07-04 |