| NPI | 1447249636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO DR.0068954) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: GA 73012) |
| 207N00000X Dermatology (Licence: TX M4224) | |
| 207P00000X Emergency Medicine (Licence: TX M4224) | |
| 207P00000X Emergency Medicine (Licence: OH 34008228J) | |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2023-05-25 |