| NPI | 1275669996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NH 15251) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 235410) |
| 207N00000X Dermatology (Licence: ME MD22699) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: NH 15251) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: MD D73683) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2025-01-13 |