NPI | 1871507236 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: IL 036073831) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036073831) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2008-03-31 |