| NPI | 1194820662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: NH 14056) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 156248) |
| 207ND0900X Dermatology, Dermatopathology (Licence: MA 156248) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2018-12-03 |