| NPI | 1396127114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: MA 283687) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 283687) |
| 207R00000X Internal Medicine (Licence: MA 264116) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2021-01-26 |