| NPI | 1437536463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 38050) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 38050) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2022-08-17 |