| NPI | 1528551181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NP0225X Dermatology, Pediatric Dermatology (Licence: PA OS021872) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA OS021872) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: PA OT018645) | |
| 207R00000X Internal Medicine (Licence: PA OT018645) | |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2023-09-18 |