| NPI | 1558981274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 125.075666) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.075666) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2021-06-12 |