| NPI | 1669119301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-008949) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 085.008949) |
| Enumeration Date | 2022-05-15 |
| Last Update Date | 2023-07-24 |