| NPI | 1184076796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0100453) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD480305) |
| 207N00000X Dermatology (Licence: VA 0101268564) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: PA MT210430) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2024-08-21 |