| NPI | 1225028699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ND 15835) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KS 04-37503) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2020-10-28 |