| NPI | 1922460161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL M144461) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 125069551) |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2022-07-21 |