| NPI | 1205330727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 59195) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R76707) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2022-09-06 |