| NPI | 1538286042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AL 29783) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 25379) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2010-01-29 |