| NPI | 1033554498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA MD-42827) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: IA MD-42827) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2023-09-22 |