NPI | 1639630114 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A176705) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125073610) |
Enumeration Date | 2019-03-27 |
Last Update Date | 2025-06-20 |