| NPI | 1407951361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0057715) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NY 186933) |
| 207N00000X Dermatology (Licence: NY 186933) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: MD D0057715) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2026-03-23 |