| NPI | 1245298009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 34.005471) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 34005471D) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2025-06-16 |