| NPI | 1063516391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX Q6791) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: IL 036116702) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2016-12-01 |