| NPI | 1093070179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO DR.0058571) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: RI LP02769) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2022-09-06 |