NPI | 1063071199 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX V8973) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2023028374) |
Enumeration Date | 2019-06-12 |
Last Update Date | 2025-10-07 |