| NPI | 1245817378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0103228) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 125.077533) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-07-10 |