| NPI | 1437544582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ID M15699) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036.150002) |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2022-04-25 |