| NPI | 1225023773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AR E-5113) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA 018949) |
| 207N00000X Dermatology (Licence: TX M6214) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: MS 15320) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2023-11-27 |