NPI | 1942453022 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036121698) |
Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036121698) |
Enumeration Date | 2008-11-03 |
Last Update Date | 2021-04-21 |