| NPI | 1134178973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: CA G80754) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G80754) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2007-11-07 |