| NPI | 1184006108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ME MD23729) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: ME MD23729) |
| 207N00000X Dermatology (Licence: MA 278298) | |
| 207ND0900X Dermatology Dermatopathology (Licence: ME MD23729) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2020-07-02 |