| NPI | 1497745541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0060148) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: HI MD-26312) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2025-11-18 |