NPI | 1336179340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: WI 44786) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 44786) |
Enumeration Date | 2006-07-04 |
Last Update Date | 2021-09-07 |