| NPI | 1730297607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036-118418) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 25215) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2015-01-12 |