| NPI | 1831504067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IL 036152483) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S0375) |
| 208000000X Pediatrics (Licence: IA DO-05910) | |
| 208000000X Pediatrics (Licence: NY 288816) | |
| 208000000X Pediatrics (Licence: IL 036152483) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IA DO-05910) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 288816) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX S0375) | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2022-01-04 |