| NPI | 1275610602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AL 28169) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AL 28169) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-11-25 |