| NPI | 1093203184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 80126) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 80126) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2025-09-25 |