| NPI | 1346730066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: TX U3884) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD477937) |
| 207R00000X Internal Medicine (Licence: AZ R76836) | |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2023-07-03 |