| NPI | 1245423854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA09188100) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD432156) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: NJ 25MA09188100) | |
| 208000000X Pediatrics (Licence: PA MD432156) | |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2024-10-03 |