| NPI | 1043411473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO DR.0058361) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 237195) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2022-07-21 |