NPI | 1457790180 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: UT 10279690-1204) |
Additional Taxonomies | 207N00000X Dermatology (Licence: TX 577682) |
Enumeration Date | 2013-06-15 |
Last Update Date | 2018-07-11 |