| NPI | 1396784443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AR E1361) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA MD201162) |
| 207P00000X Emergency Medicine (Licence: LA MD201162) | |
| 207P00000X Emergency Medicine (Licence: AR E1361) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2024-02-20 |