| NPI | 1447770672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 5101025132) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101023276) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2021-06-07 |