| 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 |