NPI | 1720072143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036074737) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036074737) |
Enumeration Date | 2005-08-31 |
Last Update Date | 2021-03-29 |