NPI | 1477659746 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: UT 49840081205) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: UT 49840081205) |
Enumeration Date | 2006-09-15 |
Last Update Date | 2021-10-20 |