NPI | 1306934534 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: KY 37630) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: KY 37630) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2020-06-09 |