| NPI | 1699715888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 69544-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-104343) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-02-01 |