| NPI | 1942408414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA 131455) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036119862) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2017-01-14 |