| NPI | 1619038171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 0109455A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036066126) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2024-08-30 |