| 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 |