| NPI | 1194740449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301059691) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301059691) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-12-17 |