| NPI | 1558456947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: CA G139000) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G139000) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2011-10-05 |