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 |