NPI | 1487625885 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS8594) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: FL OS8594) |
Enumeration Date | 2006-02-01 |
Last Update Date | 2023-06-10 |