NPI | 1225659444 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: GA 17977) |
Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036171734) |
Enumeration Date | 2020-04-28 |
Last Update Date | 2025-06-18 |