| NPI | 1184162083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 31288) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 31288) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2023-11-21 |