NPI | 1528259710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: LA MD.202680) |
Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: LA MD.202680) |
207N00000X Dermatology (Licence: TX N3169) | |
207ND0900X Dermatology Dermatopathology (Licence: TX N3169) | |
Enumeration Date | 2007-08-05 |
Last Update Date | 2016-08-09 |