NPI | 1427074517 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD D69136) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD426253) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2013-02-06 |