| NPI | 1598760977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: IL 036099109) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036099109) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: IL 036099109) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2013-09-05 |