| NPI | 1568435386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NH 13860) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0102831108) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2017-11-22 |