NPI | 1114153459 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD60359915) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301094116) |
Enumeration Date | 2009-06-01 |
Last Update Date | 2015-07-07 |