NPI | 1063855286 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35.140316) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301502950) |
207ND0900X Dermatology, Dermatopathology (Licence: MI 4301502950) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: MI 4301502950) | |
Enumeration Date | 2013-04-08 |
Last Update Date | 2023-06-29 |