| NPI | 1750794962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 67536-21) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036173669) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2025-03-21 |