| NPI | 1144303009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS8747) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS8747) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2021-01-05 |