| NPI | 1740451749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A1114666) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-049961) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2017-04-05 |