| NPI | 1659719748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: PA MT219847) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.140820) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2023-08-18 |