| NPI | 1508920398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD-073072L) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA md073072l) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2023-11-04 |