| NPI | 1083863260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036.125787) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.125787) |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2016-06-06 |