| NPI | 1124445077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036161311) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2015011944) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2022-10-17 |