| NPI | 1508972381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: GA 034420) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: IL 036-112525) |
| 207ND0900X Dermatology, Dermatopathology (Licence: NY 233885-1) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2007-07-08 |