| NPI | 1235118340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 34864) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 46855) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2024-02-09 |