| NPI | 1871908723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TX T7155) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: IL 036142309) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IL 036.142309) | |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2023-05-13 |