| NPI | 1740843127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036.162138) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.162138) |
| Enumeration Date | 2019-04-21 |
| Last Update Date | 2024-02-28 |