| NPI | 1447542162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 74215) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 54105) |
| 207N00000X Dermatology (Licence: TN MD54105) | |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2020-11-05 |