| NPI | 1356303671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: CT 26345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 26345) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2007-07-08 |