NPI | 1508360421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NY 317025) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 317025) |
Enumeration Date | 2018-03-23 |
Last Update Date | 2023-06-29 |