| NPI | 1649790627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 101902) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036.155306) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2026-04-10 |