| NPI | 1073561007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: CO 44388) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CO 44388) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-02-09 |