NPI | 1013126390 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX R5096) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10026779) |
2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX BP10026779) | |
Enumeration Date | 2007-05-22 |
Last Update Date | 2018-04-04 |