NPI | 1316478720 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0095668) |
Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101272836) |
Enumeration Date | 2017-03-27 |
Last Update Date | 2024-04-04 |