| NPI | 1982820148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: IL 036120261) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036120261) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IL 036120261) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2021-12-16 |