| NPI | 1316357874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 68778-20) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 126.064680) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2024-07-01 |