NPI | 1255518205 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NJ MA032378) |
Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: NJ MA032378) |
207NP0225X Dermatology Pediatric Dermatology (Licence: NJ MA032378) | |
207NS0135X Dermatology Procedural Dermatology (Licence: NJ MA032378) | |
Enumeration Date | 2008-01-22 |
Last Update Date | 2008-01-28 |