| NPI | 1700905981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036-094143) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 036-094143) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2022-02-28 |