NPI | 1265468417 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: FL ME70420) |
Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME70420) |
Enumeration Date | 2006-06-22 |
Last Update Date | 2017-04-26 |