| NPI | 1164842241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NP0225X Dermatology Pediatric Dermatology (Licence: CO DR.0062470) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CO DR.0062470) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2023-05-10 |