| NPI | 1346478054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KS 04-36198) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 7282) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2013-01-29 |