| NPI | 1609083963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 46189) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: TN 46189) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2023-10-02 |