| NPI | 1013105444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036.132972) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 242826) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2020-04-20 |