| NPI | 1679594055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036095041) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01058382A) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2023-07-06 |