| NPI | 1194983346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: TX N3082) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD435635) |
| 207ND0900X Dermatology, Dermatopathology (Licence: PA MD435635) | |
| 207N00000X Dermatology (Licence: TX N3082) | |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2010-07-29 |