| NPI | 1265517635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: MI 4301406190) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301406190) |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: OK 16422) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2011-10-04 |