| NPI | 1366442444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: IL 036-060267) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036-060267) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2008-01-17 |