| NPI | 1124000187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 045299) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: GA 045299) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2012-02-16 |