NPI | 1124182993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: LA L010027) |
Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: LA L010027) |
207NS0135X Dermatology, Procedural Dermatology (Licence: LA L010027) | |
Enumeration Date | 2006-12-19 |
Last Update Date | 2018-05-31 |