| NPI | 1235335712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OK 25654) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 25654) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-10-19 |