| NPI | 1285896829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: DE C1-0009352) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT185849) |
| 207ND0900X Dermatology, Dermatopathology (Licence: DE C1-0009352) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: PA MD436874) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2017-08-22 |