| NPI | 1609946292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 54674-20) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036044864) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2015-12-21 |