| NPI | 1114312410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: DC MD048379) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD048379) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2020-06-30 |