| NPI | 1114003415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 34242) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NV 15007) |
| 207N00000X Dermatology (Licence: IN 01054521A) | |
| 207Q00000X Family Medicine (Licence: NV 15007) | |
| 207Q00000X Family Medicine (Licence: IN 01054521A) | |
| Enumeration Date | 2006-10-29 |
| Last Update Date | 2024-07-12 |