| NPI | 1457705527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: PA MD482022) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME155621) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2024-07-16 |