NPI | 1063419307 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX K3730) |
Additional Taxonomies | 174400000X Specialist (Licence: AR C8433) |
Enumeration Date | 2005-07-01 |
Last Update Date | 2024-06-12 |