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 |