| NPI | 1245289594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G48584) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G48584) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2007-07-09 |