| NPI | 1841930831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 8586520) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.080213) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2025-07-04 |