| NPI | 1295301265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD AJ4147357) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-12094) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2023-08-23 |