| NPI | 1235633652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2024013120) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: MO 2024013120) |
| 207R00000X Internal Medicine (Licence: MO 2024013120) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-07-02 |