| NPI | 1164409470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA C55142) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01056458a) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-12-15 |