NPI | 1568604668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME118731) |
Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.122891) |
Enumeration Date | 2009-04-03 |
Last Update Date | 2014-06-30 |