| NPI | 1700237682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD.38396) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125068251) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2019-08-08 |