| NPI | 1144229279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA 20388) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036-054040) |
| 207N00000X Dermatology (Licence: NE 12808) | |
| 207N00000X Dermatology (Licence: CA G833882) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2007-07-08 |