| NPI | 1356721146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 62702) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015016423) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2022-03-29 |