NPI | 1649826512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: IL 125082535) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125082535) |
Enumeration Date | 2019-08-15 |
Last Update Date | 2024-06-12 |