| NPI | 1629508965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036155926) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MO 2022026074) |
| 208000000X Pediatrics (Licence: IL 125.071367) | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2024-06-04 |