| NPI | 1346395449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NP0225X Dermatology, Pediatric Dermatology (Licence: WI 37762) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 73307) |
| 207N00000X Dermatology (Licence: WI 37762) | |
| 208000000X Pediatrics (Licence: WI 37762) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2023-07-27 |