| NPI | 1396735114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036042486) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: IL 036042486) |
| 207ND0900X Dermatology, Dermatopathology (Licence: IL 036042486) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: IL 036042486) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2014-01-23 |