NPI | 1447275904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: NY 211630) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA A79859) |
207ND0900X Dermatology, Dermatopathology (Licence: NJ 25MA07004000) | |
207N00000X Dermatology (Licence: NJ 25MA07004000) | |
Enumeration Date | 2006-07-13 |
Last Update Date | 2024-04-09 |