| NPI | 1184672792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NP0225X Dermatology, Pediatric Dermatology (Licence: MO 2003005736) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: KS 0429751) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2025-10-27 |