| NPI | 1487996633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 50016) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01078868A) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2025-06-17 |