| NPI | 1588159917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 65888) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29180) |
| 207R00000X Internal Medicine (Licence: MN 65888) | |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2023-11-15 |