| NPI | 1104927078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: NY 226561) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD426361) |
| 207N00000X Dermatology (Licence: NY 226561) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: PA MD426361) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2024-11-25 |