| NPI | 1578763025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NP0225X Dermatology, Pediatric Dermatology (Licence: NY 281379) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 281379) |
| 208000000X Pediatrics (Licence: NY 281379) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2024-04-18 |