| NPI | 1346476975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OK 33281) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AR E-8742) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2018-05-16 |