NPI | 1326200569 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology (Licence: TX P8471) |
Additional Taxonomies | 207N00000X Dermatology (Licence: TX P8471) |
Enumeration Date | 2008-06-30 |
Last Update Date | 2019-02-06 |