| NPI | 1366970386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 1020567) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: RI MD17789) |
| Enumeration Date | 2017-06-03 |
| Last Update Date | 2024-10-09 |