| NPI | 1932175767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036110217) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KY 39686) |
| 207N00000X Dermatology (Licence: IN 01055117a) | |
| 207N00000X Dermatology (Licence: TN 39928) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2023-04-03 |