| NPI | 1457123523 |
|---|---|
| Former Name | XIAOXI SONG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 326710) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 76324) |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2024-02-10 |