| NPI | 1609033083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD436408) |
| Additional Taxonomies | 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: PA MT186452) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2020-06-19 |