| NPI | 1235391889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 5198) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 5198) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-07-24 |