| NPI | 1285838847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2009004969) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX M8632) |
| 207ND0900X Dermatology, Dermatopathology (Licence: MO 2009004969) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2022-07-21 |