| NPI | 1427175934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ME 018852) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301083648) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2011-12-07 |