NPI | 1538257589 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: OR MD19132) |
Additional Taxonomies | 207N00000X Dermatology (Licence: WA MD000323633) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2008-03-12 |