NPI | 1518311778 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: TX T9810) |
Additional Taxonomies | 207N00000X Dermatology (Licence: AR E-13464) |
207N00000X Dermatology (Licence: TX T9810) | |
207N00000X Dermatology (Licence: PA MT210376) | |
Enumeration Date | 2016-04-14 |
Last Update Date | 2024-10-09 |