| NPI | 1033208418 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036110291) | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036110291) | 
| Enumeration Date | 2006-10-12 | 
| Last Update Date | 2015-11-03 |