| NPI | 1053413484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: RI 5860) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: RI 5860) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2019-04-03 |