NPI | 1275578262 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA06884200) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NJ MA68842) |
Enumeration Date | 2006-06-17 |
Last Update Date | 2010-08-25 |