| NPI | 1780692525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036096583) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 68212-20) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2023-06-15 |