| NPI | 1477944841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A172646) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 125070649) |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2026-08-24 |