| NPI | 1336129667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 17178) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 17178) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2019-04-11 |