| NPI | 1467448662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AK 129488) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036114135) |
| 207Q00000X Family Medicine (Licence: IL 036-114135) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2019-08-13 |