| NPI | 1467486977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D67588) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD d67588) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2024-09-18 |