| NPI | 1730594128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036143046) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.065551) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2018-07-19 |