| NPI | 1104271816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 009641) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 009641) |
| Enumeration Date | 2016-05-01 |
| Last Update Date | 2024-04-23 |