| NPI | 1093381808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 85281-20) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IA AI-4033089-2130) |
| 207R00000X Internal Medicine (Licence: IA AI-4033089-2130) | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2025-08-01 |