NPI | 1235222928 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2005-00848) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2005-00848) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2020-04-01 |