| NPI | 1700033628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036.120211) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036120211) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2014-08-27 |