| NPI | 1295994895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KS 04-35671) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: MO 2012007468) |
| 207ND0900X Dermatology Dermatopathology (Licence: MD D83980) | |
| 207N00000X Dermatology (Licence: MO 2012007468) | |
| 207ND0900X Dermatology Dermatopathology (Licence: KS 04-35671) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2018-07-23 |