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 |