| NPI | 1396811105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 31696) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: MO 31696) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2008-05-28 |