| NPI | 1447218995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME65961) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: RI MD09968) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2014-01-31 |