NPI | 1003841248 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA G27354) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G72354) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2024-12-19 |