| NPI | 1285833459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SD pending) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 5144) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2022-04-29 |