NPI | 1396278099 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301504882) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301114438) |
207R00000X Internal Medicine (Licence: IL 125.070725) | |
Enumeration Date | 2017-04-10 |
Last Update Date | 2021-08-31 |