NPI | 1598261463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX T9054) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA 177564) |
Enumeration Date | 2018-04-01 |
Last Update Date | 2024-07-08 |