NPI | 1356567937 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A51505) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA A51505) |
Enumeration Date | 2007-04-18 |
Last Update Date | 2007-07-08 |