| NPI | 1144294240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA OP60209777) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 02001718A) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2012-04-12 |