| NPI | 1821227414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036123868) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-41434) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2015-07-01 |