| NPI | 1336235068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: UT 1617461205) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: UT 1617461205) |
| 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: UT 1617461205) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-04-18 |