| NPI | 1417279068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 50626) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: AZ 50626) |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2019-09-20 |