| NPI | 1720479496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 125.075424) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 280465) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2020-07-01 |