| NPI | 1386684512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 8592) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: AZ 8592) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2008-02-25 |