NPI | 1013150630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA A137455) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 266603-1) |
Enumeration Date | 2009-04-13 |
Last Update Date | 2023-04-21 |