| NPI | 1295849495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: LA MD.206362) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR C4839) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2024-06-03 |