NPI | 1346805090 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: IA MD-55398) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CT 74955) |
Enumeration Date | 2019-05-08 |
Last Update Date | 2025-09-16 |