| NPI | 1548482482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MS 31916) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NM md2009-0594) |
| 207N00000X Dermatology (Licence: ID M-15814) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2023-11-29 |