| NPI | 1215255526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 259741) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP01895) |
| 207N00000X Dermatology (Licence: MA 247360) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2015-03-19 |