NPI | 1154320232 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: CT 43924) |
Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NY 179433-1) |
Enumeration Date | 2005-07-20 |
Last Update Date | 2012-03-01 |