| NPI | 1932561354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 321250) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125068329) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2023-10-26 |