NPI | 1043383524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: IL 3648697) |
Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: IL 3648697) |
207NS0135X Dermatology, Procedural Dermatology (Licence: IL 3648697) | |
Enumeration Date | 2006-11-15 |
Last Update Date | 2007-12-18 |