| 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 |