| NPI | 1396792644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 140900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 140900) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2016-11-16 |