| NPI | 1245216316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ME MD17808) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01054642A) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2019-05-31 |