| NPI | 1073552261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35-081751) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: OH 35-081751) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2015-12-09 |