| NPI | 1063456226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NH 9247) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VT 042-0008974) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2013-12-29 |