| NPI | 1598923591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD447346) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT192517) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2020-08-13 |