| NPI | 1437237567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G192557) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.093755) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2024-04-15 |