| NPI | 1740855600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036171204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-12063) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2024-11-01 |