| NPI | 1306166871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 36633) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-243930) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2024-01-11 |