| NPI | 1467596080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 024945) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD0000024945) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2021-03-14 |