NPI | 1083032551 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207NP0225X Dermatology, Pediatric Dermatology (Licence: PR 19782) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PR 19782) |
Enumeration Date | 2014-04-02 |
Last Update Date | 2022-06-27 |