| NPI | 1700807187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036059296) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 023209) |
| 208000000X Pediatrics (Licence: MO R5D06) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2021-10-28 |