| NPI | 1356324495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE NE13516) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: NE NE13516) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NE NE13516) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2010-02-18 |