| NPI | 1801325782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0064316) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125070769) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2026-06-25 |