| NPI | 1528259710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: LA MD.202680) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX N3169) |
| 207ND0900X Dermatology, Dermatopathology (Licence: LA MD.202680) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: TX N3169) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2022-11-30 |