| NPI | 1114131042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35089664) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01093979A) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2024-06-26 |