| NPI | 1679563324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 254307) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036113047) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2016-03-10 |