| NPI | 1871115741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036165717) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-10214) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2026-01-08 |