| NPI | 1669059200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD600004053) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.081152) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-06-12 |