| NPI | 1073605291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ MA033718) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 1353181) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2009-10-21 |