NPI | 1073735593 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NY 252150-1) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2006-01943) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2011-01-26 |