| NPI | 1487949533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A123884) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 247616) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2015-02-11 |