| NPI | 1912569773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 19228) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036158253) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2022-07-14 |