NPI | 1770588873 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2018-02557) |
Additional Taxonomies | 174400000X Specialist (Licence: IL 036096047) |
Enumeration Date | 2005-06-15 |
Last Update Date | 2020-10-01 |