| NPI | 1578533493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WV 22066) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036174729) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2025-12-22 |