NPI | 1023020120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: WI WI16879) |
Additional Taxonomies | 207N00000X Dermatology (Licence: WI WI16879) |
Enumeration Date | 2006-08-13 |
Last Update Date | 2010-09-22 |