| NPI | 1922107002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0075734) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD034924) |
| 208000000X Pediatrics (Licence: IL 336087718) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2014-08-13 |