| NPI | 1023196938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 075586) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G85512) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-11-27 |