NPI | 1003884925 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA C37001) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA c37001) |
207ND0900X Dermatology, Dermatopathology (Licence: CA c37001) | |
Enumeration Date | 2006-03-08 |
Last Update Date | 2010-06-10 |