NPI | 1063425791 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: TN DO0000000839) |
Additional Taxonomies | 208D00000X General Practice (Licence: TN DO0000000839) |
207K00000X Allergy & Immunology (Licence: TN DO0000000839) | |
Enumeration Date | 2006-08-14 |
Last Update Date | 2015-09-10 |