NPI | 1508052036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX N9211) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD438676) |
Enumeration Date | 2007-09-18 |
Last Update Date | 2011-08-05 |