| NPI | 1346230273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: HI MD13649) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: DC MD31931) |
| 207N00000X Dermatology (Licence: WY 8214A) | |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2019-09-24 |