| NPI | 1093030462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD454380) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: DE C1-0012141) |
| 207ND0900X Dermatology, Dermatopathology (Licence: PA MD454380) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: DE C1-0012141) | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2018-03-20 |