| NPI | 1093884843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 36909) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 27315) |
| 207R00000X Internal Medicine (Licence: AZ 27315) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2019-11-07 |