| NPI | 1811491525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IL 036.155466) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C7-0006775) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2021-06-29 |