| NPI | 1033792668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA MD-54866) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: IA MD-54866) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: IA MD-54866) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: IA MD-54866) | |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2025-07-07 |