| NPI | 1558386136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: PA MD071674L) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD071674L) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2012-10-23 |