| NPI | 1447593686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS13968) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.063879) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2021-05-19 |