| NPI | 1396171484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MS 29348) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A157592) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2025-07-23 |