| NPI | 1831695899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 83855-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.155530) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2024-04-25 |