| NPI | 1497828701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0024130) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101037048) |
| 207N00000X Dermatology (Licence: DC MD039143) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2011-11-16 |