NPI | 1245454404 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: LA 203620) |
Additional Taxonomies | 207N00000X Dermatology (Licence: LA e-6101) |
Enumeration Date | 2007-04-12 |
Last Update Date | 2013-06-25 |