| NPI | 1386586220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 3020509) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 3020509) |
| Enumeration Date | 2026-04-08 |
| Last Update Date | 2026-04-08 |