| NPI | 1386964237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 265544) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244742) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2018-03-17 |