| NPI | 1467555359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA C166853) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KS 04-31416) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2024-12-13 |