NPI | 1538382528 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NE 724) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 724) |
Enumeration Date | 2007-04-10 |
Last Update Date | 2018-03-28 |