| NPI | 1558898395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX BP10060897) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10060897) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-06-18 |