| NPI | 1619026135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IL 036-135564) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D68804) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2014-11-05 |