| NPI | 1891788105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036-051235) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: IL 036-051235) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2012-09-12 |