| NPI | 1801811591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: RI MD16312) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-114875) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2021-04-27 |