| NPI | 1861696262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P8461) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL P8461) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: ND 10828) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IL 036148243) | |
| 208000000X Pediatrics (Licence: OH 57011356) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2024-04-09 |