| NPI | 1295050722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 269594) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NY 269594) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2015-06-05 |