| NPI | 1467673061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036-125576) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 125-051629) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2012-02-17 |