| NPI | 1063435741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G20623) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G20623) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-08-19 |