| NPI | 1144203092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35.088883) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01055546A) |
| 207N00000X Dermatology (Licence: SC 27830) | |
| 207ND0900X Dermatology Dermatopathology (Licence: SC 27830) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: IN 01055546A) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: SC 27830) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2015-02-09 |