| NPI | 1417955584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036-043409) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME114654) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2016-11-15 |