| NPI | 1194823484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MT 4053) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: HI 11958) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2014-04-24 |