| NPI | 1285616839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 28389) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: GA 11448) |
| 174400000X Specialist (Licence: SC 28389) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2012-07-02 |