| NPI | 1619971157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: IL 036073084) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036073084) |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: IL 036073084) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2016-01-05 |