| NPI | 1073589297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 36106158) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 36106158) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-12-07 |