| NPI | 1710514138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036.167645) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.167645) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-06-30 |