| NPI | 1447372446 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: OH 35.091459)  | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.091459)  | 
| Enumeration Date | 2007-04-03 | 
| Last Update Date | 2021-12-27 |