| NPI | 1144208158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2008-00083) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35081826D) |
| 207P00000X Emergency Medicine (Licence: IN 01039578) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: OH 35-081826) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: NC 2008-00083) | |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2012-01-28 |