| NPI | 1407836877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 5101010630) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL OS14651) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2024-05-22 |