NPI | 1548366727 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA A68814) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A688140) |
Enumeration Date | 2006-09-15 |
Last Update Date | 2016-11-09 |