| NPI | 1013957133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME96233) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01058940A) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2014-09-30 |