| NPI | 1295701456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: LA 021910) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX J9788) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2023-11-14 |