| NPI | 1750793253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MS 26942) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036164860) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2026-07-17 |