| NPI | 1497711972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME153436) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME153436) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2024-02-05 |