| NPI | 1902972516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036089109) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.11359R) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2013-03-26 |