| NPI | 1417158833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX N3356) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: TX N3356) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-03-07 |