NPI | 1194942151 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: CO 2226) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NY 303395) |
Enumeration Date | 2007-04-19 |
Last Update Date | 2023-07-03 |