| NPI | 1023022027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD440119) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: PA MD440119) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2018-12-12 |