| NPI | 1467958785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OK 41009) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX T5825) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2023-11-16 |