| NPI | 1184919508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036.137877) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036137877) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: IL 036.137877) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2022-05-27 |