NPI | 1295926574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX M9537) |
Additional Taxonomies | 207N00000X Dermatology (Licence: LA MD.201378) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2013-07-18 |