| NPI | 1235396425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 57229) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036116569) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2021-01-12 |