NPI | 1053547885 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: MI 4301100629) |
Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: GA 74802) |
Enumeration Date | 2009-06-08 |
Last Update Date | 2018-10-18 |