| NPI | 1437238839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A21297) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: CA A21297) |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: CA A21297) | |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2018-08-06 |