| NPI | 1144297318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA0451770) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NJ 25MA0451770) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: NJ 25MA0451770) | |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2023-11-09 |