| NPI | 1790865806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 66663) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036086146) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2022-07-26 |