| NPI | 1124022801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ID M11887) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01054306a) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2014-02-05 |