| NPI | 1063684348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 32347) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036.127872) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2020-07-14 |