NPI | 1033555230 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CO 0061328) |
Additional Taxonomies | 207N00000X Dermatology (Licence: WY 6858A) |
Enumeration Date | 2013-05-14 |
Last Update Date | 2021-09-27 |