| NPI | 1699939595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60143671) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125053667) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2022-12-12 |