| NPI | 1295831360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL 44597) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: FL 44597) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2022-12-01 |