| NPI | 1538161583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IN 1030824) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KY 21622) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2014-12-17 |