| NPI | 1164743928 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX Q6972) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 02003977A) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2024-02-21 |