| NPI | 1639696107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IL 036.164638) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: IL 036.164638) | |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2023-05-09 |