| NPI | 1245640705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0103635) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 274028) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2025-06-24 |