| NPI | 1962577676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036-077856) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: ID 036-077856) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2021-04-23 |