| NPI | 1326070657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A84131) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A84131) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2019-11-21 |