| NPI | 1871869438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036143080) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: IL 036.143080) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2022-04-13 |