| NPI | 1306872288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 5101016099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101016099) |
| 208M00000X Hospitalist (Licence: MI 5101016099) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2023-01-16 |