| NPI | 1497744536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NP0225X Dermatology Pediatric Dermatology (Licence: NY 180071) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 180071) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2024-04-29 |